1 Data

\(\text{Table}\:\text{1.}\) Robot vs LPS+LESS
Robot LPS+LESS
NxUx 454 1532 1986
Segmental 25 13 38
479 1545 2024


1.1 Baseline

Patient’s Baseline Characteristics
level 1 ROBOT 2 LPS+LESS p test SMD
n 479 1545
NUx (%) 1 ROBOT 454 (94.8) 0 ( 0.0) <0.001 16.493
2 LPS+LESS 0 ( 0.0) 1532 (99.2)
NA 25 ( 5.2) 13 ( 0.8)
Segmental (%) 1 ROBOT 25 ( 5.2) 0 ( 0.0) <0.001 0.357
2 LPS+LESS 0 ( 0.0) 13 ( 0.8)
NA 454 (94.8) 1532 (99.2)
ECOG (%) 0 無症狀 248 (51.8) 609 (39.4) <0.001 0.521
1 有症狀,可步行對生活不影響 187 (39.0) 536 (34.7)
2 躺在床上時間小於50% 22 ( 4.6) 83 ( 5.4)
3 躺在床上時間大於50% 3 ( 0.6) 9 ( 0.6)
4 完全臥床 0 ( 0.0) 4 ( 0.3)
NA 19 ( 4.0) 304 (19.7)
性別 (%) 1 男 202 (42.2) 636 (41.2) 0.736 0.020
2 女 277 (57.8) 909 (58.8)
BMI (%) 1 Normal 228 (47.6) 582 (37.7) <0.001 0.321
2 Overweight 133 (27.8) 354 (22.9)
NA 118 (24.6) 609 (39.4)
Cell_Type (%) 1 urothelial 414 (86.4) 1390 (90.0) 0.090 0.111
5 UC with variants (Squamous cell, glandular, sarcomatous, micro papillary, neuroendocrine, lymphoepithelial) 61 (12.7) 147 ( 9.5)
6 others 4 ( 0.8) 8 ( 0.5)
左右側 (%) 1 左 249 (52.0) 802 (51.9) 0.990 0.008
2 右 223 (46.6) 719 (46.5)
3 雙側 7 ( 1.5) 24 ( 1.6)
腫瘤位置 (%) 0 non-visible 1 ( 0.2) 1 ( 0.1) 0.517 0.104
1 腎盂 186 (38.8) 655 (42.4)
2 輸尿管 175 (36.5) 500 (32.4)
3 膀胱袖口 1 ( 0.2) 2 ( 0.1)
4 多個位置 115 (24.0) 385 (24.9)
5 無法識別 1 ( 0.2) 2 ( 0.1)
多發性 (%) 0 Not available 19 ( 4.0) 92 ( 6.0) 0.246 0.092
1 No 295 (61.6) 936 (60.6)
2 Yes 165 (34.4) 517 (33.5)
腫瘤大小 (%) 0 Not available 7 ( 1.5) 56 ( 3.6) 0.050 0.141
1 <2cm 153 (31.9) 462 (29.9)
2 >=2cm 319 (66.6) 1027 (66.5)
病理分期 (%) 1 stage 0a/0is 73 (15.2) 241 (15.6) 0.018 0.185
2 stage I 118 (24.6) 436 (28.2)
3 stage II 79 (16.5) 296 (19.2)
4 stage III 144 (30.1) 442 (28.6)
5 stage IV 52 (10.9) 106 ( 6.9)
NA 13 ( 2.7) 24 ( 1.6)
完整檢體腫瘤惡性度 (%) 1 papillary urothelial neoplasm of low malignant potential 1 ( 0.2) 1 ( 0.1) 0.185 0.124
2 low grade 47 ( 9.8) 140 ( 9.1)
3 high grade 418 (87.3) 1372 (88.8)
4 Gx 2 ( 0.4) 15 ( 1.0)
NA 11 ( 2.3) 17 ( 1.1)
合併膀胱腫瘤 (%) 0 No 356 (74.3) 1078 (69.8) 0.096 0.159
1 Previous Hx of bladder UC 33 ( 6.9) 114 ( 7.4)
2 Concurrent Bladder UC 70 (14.6) 261 (16.9)
3 Not available 14 ( 2.9) 41 ( 2.7)
NA 6 ( 1.3) 51 ( 3.3)
合併CIS (%) 0 No 323 (67.4) 1060 (68.6) 0.062 0.133
1 Yes 149 (31.1) 434 (28.1)
NA 7 ( 1.5) 51 ( 3.3)
Lymphovascular_invasion (%) 0 No 366 (76.4) 1256 (81.3) <0.001 0.189
1 Yes 92 (19.2) 267 (17.3)
NA 21 ( 4.4) 22 ( 1.4)
surgical_margin (%) 0 free 449 (93.7) 1472 (95.3) 0.066 0.117
1 positive 26 ( 5.4) 51 ( 3.3)
NA 4 ( 0.8) 22 ( 1.4)
術前水腎 (%) 1 No 207 (43.2) 719 (46.5) 0.137 0.106
2 Yes 258 (53.9) 761 (49.3)
NA 14 ( 2.9) 65 ( 4.2)
Tumor_Necrosis (%) 0 No 412 (86.0) 1133 (73.3) <0.001 0.439
1 Yes 57 (11.9) 208 (13.5)
NA 10 ( 2.1) 204 (13.2)
有無針對UTUC化療 (%) 0 No 321 (67.0) 1075 (69.6) 0.018 0.155
1 Yes 148 (30.9) 404 (26.1)
2 Not available 10 ( 2.1) 66 ( 4.3)
針對UTUC化療型態 (%) 0 No & Unknown 331 (69.1) 1139 (73.7) 0.008 0.176
1 neo-adjuvant 20 ( 4.2) 42 ( 2.7)
2 adjuvant 92 (19.2) 297 (19.2)
3 salvage (curative intent) 13 ( 2.7) 15 ( 1.0)
4 palliative (S/S relieve) 23 ( 4.8) 52 ( 3.4)
化療處方 (%) 0 No & Unknown 336 (70.1) 1150 (74.4) 0.079 0.151
1 Gemcitabine & cisplatin 39 ( 8.1) 125 ( 8.1)
2 MVAC 10 ( 2.1) 11 ( 0.7)
3 Taxans-based 0 ( 0.0) 1 ( 0.1)
4 Carboplatin-based 49 (10.2) 141 ( 9.1)
5 others 45 ( 9.4) 117 ( 7.6)
Bladder_cuff_resection (%) 0 Not perform BCR 11 ( 2.3) 47 ( 3.0) <0.001 2.194
1 Open incision 92 (19.2) 1027 (66.5)
2 Transurethral incision 9 ( 1.9) 55 ( 3.6)
4 Laparoscopy 6 ( 1.3) 306 (19.8)
5 Robot assisted 321 (67.0) 5 ( 0.3)
NA 40 ( 8.4) 105 ( 6.8)
simultaneously_ipsilateral_adrenalectomy (%) 0 No 408 (85.2) 1205 (78.0) 0.001 0.202
1 Yes 26 ( 5.4) 95 ( 6.1)
NA 45 ( 9.4) 245 (15.9)
Post_operation_intravesical_CT_instillation (%) 1 No 356 (74.3) 1370 (88.7) <0.001 0.477
2 術中膀胱灌藥 41 ( 8.6) 6 ( 0.4)
3 術後膀胱灌藥 38 ( 7.9) 51 ( 3.3)
NA 44 ( 9.2) 118 ( 7.6)
Clavien_Dindo_classification (%) 0 No Complication 284 (59.3) 905 (58.6) 0.011 0.243
1 Grade I 78 (16.3) 175 (11.3)
2 Grade II 76 (15.9) 239 (15.5)
3 Grade IIIa 4 ( 0.8) 14 ( 0.9)
4 Grade IIIb 4 ( 0.8) 21 ( 1.4)
5 Grade IVa 3 ( 0.6) 16 ( 1.0)
6 Grade IVb 0 ( 0.0) 1 ( 0.1)
7 Grade V 3 ( 0.6) 6 ( 0.4)
NA 27 ( 5.6) 168 (10.9)
Disease_free (%) 0 No 361 (75.4) 1281 (82.9) <0.001 0.187
1 Yes 118 (24.6) 264 (17.1)
Mortality (%) 0 No 340 (71.0) 924 (59.8) <0.001 0.237
1 Yes 139 (29.0) 621 (40.2)
術後住院天數_day (mean (SD)) 7.60 (4.16) 8.44 (5.67) 0.004 0.168
手術到死亡間隔時間_月 (mean (SD)) 24.10 (17.50) 38.73 (32.69) <0.001 0.558
診斷年紀 (mean (SD)) 69.29 (10.23) 68.74 (10.49) 0.309 0.054
Followup (mean (SD)) 48.01 (95.82) 52.86 (40.04) 0.115 0.066
Followup_DF (mean (SD)) 31.35 (22.81) 39.23 (31.63) <0.001 0.286

1.2 Missing Value

2 Imputation

We utilize MICE to impute the missing value, since too much missing value.

2.1 MICE

MICE stands for Multivariate Imputation by Chained Equations. It is a statistical method used to handle missing data in a dataset. The process uses multiple imputation techniques to fill in the missing data and then combines the results from multiple imputations to produce a final imputed dataset.

\(\text{Table}\:\text{2.}\) Robot vs LPS+LESS after imputing and cleaning
Robot LPS+LESS
NxUx 424 1147 1571
Segmental 24 10 34
448 1157 1605


Patient’s Baseline after MICE
level 1 Robot 2 LPS+LESS p test SMD
n 448 1157
NUx (%) 1 ROBOT 424 (100.0) 0 ( 0.0) <0.001 NaN
2 LPS+LESS 0 ( 0.0) 1147 (100.0)
Segmental (%) 1 ROBOT 24 (100.0) 0 ( 0.0) <0.001 NaN
2 LPS+LESS 0 ( 0.0) 10 (100.0)
ECOG (%) 0 無症狀 248 ( 55.4) 564 ( 48.7) 0.077 0.173
1 有症狀,可步行對生活不影響 176 ( 39.3) 501 ( 43.3)
2 躺在床上時間小於50% 21 ( 4.7) 77 ( 6.7)
3 躺在床上時間大於50% 3 ( 0.7) 9 ( 0.8)
4 完全臥床 0 ( 0.0) 6 ( 0.5)
性別 (%) 1 男 188 ( 42.0) 473 ( 40.9) 0.735 0.022
2 女 260 ( 58.0) 684 ( 59.1)
BMI (%) 1 Normal 287 ( 64.1) 709 ( 61.3) 0.330 0.058
2 Overweight 161 ( 35.9) 448 ( 38.7)
Cell_Type (%) 1 urothelial 386 ( 86.2) 1017 ( 87.9) 0.412 0.070
5 UC with variants 58 ( 12.9) 135 ( 11.7)
6 others 4 ( 0.9) 5 ( 0.4)
左右側 (%) 1 左 227 ( 50.7) 608 ( 52.5) 0.795 0.038
2 右 214 ( 47.8) 532 ( 46.0)
3 雙側 7 ( 1.6) 17 ( 1.5)
腫瘤位置 (%) 0 non-visible 1 ( 0.2) 1 ( 0.1) 0.760 0.074
1 腎盂 174 ( 38.8) 484 ( 41.8)
2 輸尿管 163 ( 36.4) 391 ( 33.8)
3 膀胱袖口 1 ( 0.2) 2 ( 0.2)
4 多個位置 109 ( 24.3) 279 ( 24.1)
多發性 (%) 0 Not available 10 ( 2.2) 20 ( 1.7) 0.560 0.059
1 No 279 ( 62.3) 750 ( 64.8)
2 Yes 159 ( 35.5) 387 ( 33.4)
腫瘤大小 (%) 0 Not available 5 ( 1.1) 10 ( 0.9) 0.197 0.099
1 <2cm 144 ( 32.1) 322 ( 27.8)
2 >=2cm 299 ( 66.7) 825 ( 71.3)
病理分期 (%) 1 stage 0a/0is 76 ( 17.0) 205 ( 17.7) 0.243 0.126
2 stage I 115 ( 25.7) 296 ( 25.6)
3 stage II 74 ( 16.5) 218 ( 18.8)
4 stage III 136 ( 30.4) 355 ( 30.7)
5 stage IV 47 ( 10.5) 83 ( 7.2)
完整檢體腫瘤惡性度 (%) 1 papillary urothelial neoplasm of low malignant potential 1 ( 0.2) 0 ( 0.0) 0.394 0.075
2 low grade 48 ( 10.7) 126 ( 10.9)
3 high grade 395 ( 88.2) 1024 ( 88.5)
4 Gx 4 ( 0.9) 7 ( 0.6)
合併膀胱腫瘤 (%) 0 No 341 ( 76.1) 857 ( 74.1) 0.745 0.063
1 Previous Hx of bladder UC 30 ( 6.7) 95 ( 8.2)
2 Concurrent Bladder UC 68 ( 15.2) 179 ( 15.5)
3 Not available 9 ( 2.0) 26 ( 2.2)
合併CIS (%) 0 No 311 ( 69.4) 822 ( 71.0) 0.562 0.036
1 Yes 137 ( 30.6) 335 ( 29.0)
Lymphovascular_invasion (%) 0 No 359 ( 80.1) 946 ( 81.8) 0.497 0.041
1 Yes 89 ( 19.9) 211 ( 18.2)
surgical_margin (%) 0 Free 423 ( 94.4) 1121 ( 96.9) 0.030 0.121
1 Positive 25 ( 5.6) 36 ( 3.1)
術前水腎 (%) 0 No 197 ( 44.0) 512 ( 44.3) 0.964 0.006
1 Yes 251 ( 56.0) 645 ( 55.7)
Tumor_Necrosis (%) 0 No 391 ( 87.3) 983 ( 85.0) 0.269 0.067
1 Yes 57 ( 12.7) 174 ( 15.0)
有無針對UTUC化療 (%) 0 No 309 ( 69.0) 824 ( 71.2) 0.675 0.049
1 Yes 133 ( 29.7) 319 ( 27.6)
2 Not available 6 ( 1.3) 14 ( 1.2)
針對UTUC化療型態 (%) 0 No & Unknown 315 ( 70.3) 836 ( 72.3) 0.167 0.132
1 neo-adjuvant 18 ( 4.0) 37 ( 3.2)
2 adjuvant 84 ( 18.8) 233 ( 20.1)
3 salvage (curative intent) 10 ( 2.2) 11 ( 1.0)
4 palliative (S/S relieve) 21 ( 4.7) 40 ( 3.5)
化療處方 (%) 0 No & Unknown 319 ( 71.2) 842 ( 72.8) NaN 0.144
1 Gemcitabine & cisplatin 32 ( 7.1) 109 ( 9.4)
2 MVAC 10 ( 2.2) 11 ( 1.0)
3 Taxans-based 0 ( 0.0) 0 ( 0.0)
5 others 87 ( 19.4) 195 ( 16.9)
Bladder_cuff_resection (%) 0 Not perform BCR 12 ( 2.7) 47 ( 4.1) <0.001 2.409
1 Open incision 91 ( 20.3) 763 ( 65.9)
2 Transurethral incision 11 ( 2.5) 57 ( 4.9)
4 Laparoscopy 6 ( 1.3) 286 ( 24.7)
5 Robot assisted 328 ( 73.2) 4 ( 0.3)
simultaneously_ipsilateral_adrenalectomy (%) 0 No 422 ( 94.2) 1073 ( 92.7) 0.355 0.059
1 Yes 26 ( 5.8) 84 ( 7.3)
Post_operation_intravesical_CT_instillation (%) 0 No 372 ( 83.0) 1102 ( 95.2) <0.001 0.439
1 術中膀胱灌藥 37 ( 8.3) 6 ( 0.5)
2 術後膀胱灌藥 39 ( 8.7) 49 ( 4.2)
Clavien_Dindo_classification (%) 0 No Complication 284 ( 63.4) 741 ( 64.0) 0.677 0.130
1 Grade I 78 ( 17.4) 174 ( 15.0)
2 Grade II 72 ( 16.1) 187 ( 16.2)
3 Grade IIIa 4 ( 0.9) 11 ( 1.0)
4 Grade IIIb 4 ( 0.9) 21 ( 1.8)
5 Grade IVa 3 ( 0.7) 16 ( 1.4)
6 Grade IVb 0 ( 0.0) 1 ( 0.1)
7 Grade V 3 ( 0.7) 6 ( 0.5)
Disease_free (%) 0 No 341 ( 76.1) 938 ( 81.1) 0.032 0.121
1 Yes 107 ( 23.9) 219 ( 18.9)
Mortality (%) 0 No 321 ( 71.7) 778 ( 67.2) 0.100 0.096
1 Yes 127 ( 28.3) 379 ( 32.8)
術後住院天數_day (mean (SD)) 7.60 (4.16) 8.47 (5.74) 0.004 0.172
診斷年紀 (mean (SD)) 69.38 (10.16) 69.25 (10.11) 0.824 0.012
Followup (mean (SD)) 43.89 (30.48) 51.35 (39.23) <0.001 0.212
Followup_DF (mean (SD)) 31.41 (22.57) 37.20 (30.14) <0.001 0.218

3 Overlap Weighting

After

after overlap weighting
level 1 Robot 2 LPS+LESS p test SMD
n 448.0 1157.0
Clavien_Dindo_classification (%) 0 No Complication 254.1 (56.7) 740.0 (64.0) 0.339 0.229
1 Grade I 79.3 (17.7) 164.3 (14.2)
2 Grade II 101.1 (22.6) 212.1 (18.3)
3 Grade IIIa 8.9 ( 2.0) 11.7 ( 1.0)
4 Grade IIIb 4.2 ( 0.9) 15.8 ( 1.4)
5 Grade IVa 0.1 ( 0.0) 8.5 ( 0.7)
6 Grade IVb 0.0 ( 0.0) 1.0 ( 0.1)
7 Grade V 0.2 ( 0.0) 3.6 ( 0.3)
術後住院天數_day (mean (SD)) 7.36 (3.39) 8.00 (5.24) 0.075 0.144
Mortality (%) 0 No 302.0 (67.4) 809.1 (69.9) 0.587 0.054
1 Yes 146.0 (32.6) 347.9 (30.1)
Followup (mean (SD)) 51.02 (32.44) 51.30 (38.21) 0.933 0.008
Disease_free (%) 0 No 344.8 (77.0) 932.1 (80.6) 0.359 0.088
1 Yes 103.2 (23.0) 224.9 (19.4)
Followup_DF (mean (SD)) 36.61 (24.99) 36.52 (29.49) 0.973 0.003

Before

before overlap weighting
level 1 Robot 2 LPS+LESS p test SMD
n 448 1157
Clavien_Dindo_classification (%) 0 No Complication 284 (63.4) 741 (64.0) 0.677 0.130
1 Grade I 78 (17.4) 174 (15.0)
2 Grade II 72 (16.1) 187 (16.2)
3 Grade IIIa 4 ( 0.9) 11 ( 1.0)
4 Grade IIIb 4 ( 0.9) 21 ( 1.8)
5 Grade IVa 3 ( 0.7) 16 ( 1.4)
6 Grade IVb 0 ( 0.0) 1 ( 0.1)
7 Grade V 3 ( 0.7) 6 ( 0.5)
術後住院天數_day (mean (SD)) 7.60 (4.16) 8.47 (5.74) 0.004 0.172
Mortality (%) 0 No 321 (71.7) 778 (67.2) 0.100 0.096
1 Yes 127 (28.3) 379 (32.8)
Followup (mean (SD)) 43.89 (30.48) 51.35 (39.23) <0.001 0.212
Disease_free (%) 0 No 341 (76.1) 938 (81.1) 0.032 0.121
1 Yes 107 (23.9) 219 (18.9)
Followup_DF (mean (SD)) 31.41 (22.57) 37.20 (30.14) <0.001 0.218

4 Modeling

  • CD：Clavien_Dindo_classification
  • MOR：Mortality
  • DF：Disease_free
  • LOS：術後住院天數_day

4.1 p-value

4.2 coefficients

CD

MOR

DF

LOS

5 Survival Curve

OS

DFS